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Alzheimer’s Disease: What You Can Expect At Seven Different Stages


Has your beloved mother or father been diagnosed with Alzheimer’s disease? That can be hard news to take in. But caregivers should know that there is considerable research on what to expect and what you can do to preserve your loved one’s quality of life.

Scientists have identified seven stages to Alzheimer’s. Few patients will be diagnosed at the first stage, and many will not be diagnosed until the third or fourth stage. The following information may help you and your doctor determine what stage your loved one is in. With that information in hand, your doctor can recommend the best treatment program for that stage.

Stage one

In its first stage, Alzheimer’s disease has no behavioral symptoms. The only way to detect it is with a specialized brain scan. That’s why Alzheimer’s is rarely diagnosed at this stage.

Stage two

Stage two of Alzheimer’s involves a modicum of forgetfulness. However, it is important to know that a certain amount of forgetfulness and diffuse focus are a normal part of aging. In general, more than half of people over 65 think they are forgetting things they should remember. Adult children must be careful not to jump to any conclusions about Alzheimer’s or dementia based on a few instances of forgetting or a parent who confesses to forgetting a birthday or a bill. If a parent is willing to undergo a brain scan and other examinations, the disease may be diagnosable at this stage.

Stage three

This stage is characterized by what scientists call “mild cognitive impairment.” This could take the form of asking the same question more than once. It could manifest as difficulty organizing an event, like a birthday party for a grandchild. If mom or dad is still working, it will manifest as a difficulty learning new things, like computer software upgrades, on the job.

Stage four

Stage four lasts an average of two years. At this stage, the patient has difficulty with financial obligations like paying utility bills, keeping track of the day of the month, and writing checks. The patient may also have difficulty shopping for groceries for himself and his family. Alzheimer’s is relatively easy to diagnose at this stage. This is also a good stage at which to hire home care for a parent with Alzheimer’s who is living alone.

Stage five

This stage lasts an average of one and a half years. Doctors refer to this stage as “moderate Alzheimer’s” while also noting that such patients are not capable of living alone without support. The patient in this stage may forget his address, forget to pay bills, forget to change clothes and dress for the weather. Patients at this stage of Alzheimer’s are vulnerable to being taken advantage of. They are also sometimes scared and angry with loved ones if they fail to understand what a loved one is doing, saying, or thinking.

Stage six

This stage is likely to last approximately two and a half years, and it is characterized by progressive decline. The patient develops the inability to dress himself. Then, he may have difficulty running a bath that is the right temperature, followed by a general inability to bathe himself. Later, the patient will need help brushing his teeth. As this stage progresses, the patient is likely to have trouble identifying loved ones or knowing what the weather is outside. Toward the end of stage six, the patient will need to wear a diaper. Home care aides are well-trained to handle the problem of toilet hygiene. They will make sure a patient changes his diaper and maintains hygiene through bathing and proper toilet practices.

Stage seven

Doctor’s refer to this stage as “severe Alzheimer’s disease.” Speech becomes seriously impaired. The patient may speak only six words, and this can progress to being entirely non-verbal. The patient is likely to lose the ability to walk without assistance. The patient is at risk of falling out of his chair, so he will need to be accompanied while walking and sitting unless placed in a reclining chair with tall arms. The patient may develop contractures, typically of the wrist and elbow. This will look like a hand that is held at an angle for no apparent reason. The patient will lose the ability to hold his head up without help, and he loses the ability to smile.

Many Alzheimer’s patients can continue to live at home, with the right home care, for many years. You will want to discuss home care needs with your parent’s doctor and with your local home care agency.